Aktan, Adem

Aktan, Adem

Name Variants

Aktan, A.
Aktan, Adem

Job Title

Doç. Dr.

Main Affiliation

Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü

Status

Current Staff

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Scholarly Output

30

Articles

29

Citation Count

0

Supervised Theses

0 Scholarly Output Search Results

Now showing 1 - 10 of 26

Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?
(ELSEVIER, 2023) Günlü, Serhat; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, Muhammed
Background In this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (≥75 years) than in younger (<75 years) patients. Methods This retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically signifcant hematoma (CSH), pericardial efusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point. Results The overall sample included 1923 patients (1419<75 years and 504 aged≥75 years). There was no diference between the groups in terms of cumulative events defned as primary outcome (3.5% vs. 4.4%, p=0.393). Infection related to device system was signifcantly higher in the≥75 age group (1.8% vs. 3.4%, p=0.034). There was no signifcant diference between the groups in terms of clinically signifcant hematoma and pneumothorax (0.7% vs. 0.4%, p=0.451, 1.4% vs. 1.0%, p=0.477, respectively). In multivariate model analysis, no association was found between age≥75 years and infection related to the device system. Conclusion Infection rates were relatively higher in the patient group aged≥75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.
Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?
(Springer, 2023) Günlü, Serhat; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, Muhammed
Background: In this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (≥ 75 years) than in younger (< 75 years) patients. Methods: This retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point. Results: The overall sample included 1923 patients (1419 < 75 years and 504 aged ≥ 75 years). There was no difference between the groups in terms of cumulative events defined as primary outcome (3.5% vs. 4.4%, p = 0.393). Infection related to device system was significantly higher in the ≥ 75 age group (1.8% vs. 3.4%, p = 0.034). There was no significant difference between the groups in terms of clinically significant hematoma and pneumothorax (0.7% vs. 0.4%, p = 0.451, 1.4% vs. 1.0%, p = 0.477, respectively). In multivariate model analysis, no association was found between age ≥ 75 years and infection related to the device system. Conclusion: Infection rates were relatively higher in the patient group aged ≥ 75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.
Effect of cardio-gastric interaction on atrial fibrillation in GERD patients
(2023) Günlü, Serhat; Aktan, Adem; Kayan, Fethullah; Karahan, Mehmet Zülkif; Bernas, Altıntaş; Karahan, Mehmet Zülkif
Objective: Atrial fibrillation (AF) and gastroesophageal reflux disease (GERD) are very common in daily clinical practice. Post-prandial AF episodes have been reported in GERD patients. Although it was reported in previous studies that it was caused by sympathovagal imbalance, there are no studies on cardiac conduction system involvement. In this study, we aimed to evaluate whether the risk of developing AF increases in untreated GERD patients with non-invasive electrophysiological tests. Methods: The research was prospectively performed. Endoscopy was performed on the individuals due to reflux complaints. ECG was recorded at 25mm/s and 10 mm/mV amplitude, and 24-hour Holter ECG (three-channel; V1, V2, and V5) was performed. ECG parameters were measured and Holter ECG results were analyzed. Results: A total of 120 individuals, 60 patients and 60 controls, were included. No significant statistically differences existed between groups for hypertension, diabetes, smoking, or dyslipidemia (p>0.05). In terms of heart rate, Pmax, Pmin, QTd, and QTcd, there were no significant differences across the two groups (p>0.05). P-wave dispersion (Pd) was substantially higher in the study group (p=0.014). Comparing the heart rate variabilities of 24-hour Holter ECG recordings across the groups, the standard deviation of R-R intervals (SDNN) was substantially higher in the study group (p<0.001). Low Frequency (LF) and LF/HF were significantly higher in the control group (p<0.001 and p=0.003, respectively). AF was detected in nine individuals on Holter ECG. Conclusion: Pd duration and risk of developing AF were higher in GERD patients.
Evaluation of Frontal QRS-T Angle in Patients with Coronary Artery Ectasia
(Sociedade Brasileira de Cardiologia, 2023) Karahan, Mehmet Zülkif; Aktan, Adem; Kayan, Fethullah; Günlü, Serhat; Günlü, Serhat
Background: Coronary artery ectasia (CAE) is defined by focal enlargement of the coronary artery exceeding 1.5 times the adjacent normal segment. CAE can often cause arrhythmias, heart failure, sudden death, and myocardial ischemia. Ischemia due to microvascular dysfunction may be responsible for the ventricular heterogeneity in CAE. Objectives: The aim of our study was to evaluate the frontal QRS-T angle in patients with CAE. Methods: Our study included 55 patients with CAE and 50 individuals in the control group. Demographic characteristics and electrocardiographic parameters were compared between the two groups. Categorical variables were compared using the chi-square test. Continuous variables were compared using unpaired Student’s t-test. P values < 0.05 were considered statistically significant. The frontal QRS-T angle was calculated from 12-lead electrocardiograms (ECGs) using the automatic report from the electrocardiography machine. Results: The average age of patients with CAE was 63.2 ± 3.4 years, with 18 women among them. The control group had an average age of 61.1 ± 3.2 years, with 28 women included. There was no significant difference in demographic parameters between the two groups. Compared to the control group, patients with CAE had significantly wider frontal QRS-T angle (p < 0.001), as well as longer QTmax duration, p = 0.002; Tp-Te interval, p = 0.02; and QT dispersion (QTd), p = 0.04. Conclusion: The frontal QRS-T angle can be calculated easily and time-efficiently using surface electrocardiography. In this study, we showed for the first time that the frontal QRS-T angle was significantly increased in patients with CAE
Evaluation of Hematological Parameters After Transcatheter Aortic Valve Replacement
(Sage Journals, 2023) Karahan, Mehmet Zülkif; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Günlü, Serhat; Demir, Muhammed; Ertaş, Faruk
Although transcatheter aortic valve replacement (TAVR) is safe and effective, mortality and bleeding events post procedure are important. The present study investigated the changes in hematologic parameters to evaluate whether they predict mortality or major bleeding. We enrolled 248 consecutive patients (44.8% male; mean age 79.0 ± 6.4 years) undergoing TAVR. In addition to demographic and clinical examination, blood parameters were recorded before TAVR, at discharge, 1 month and 1 year. Hemoglobin levels before TAVR 12.1 ± 1.8 g/dL, 10.8 ± 1.7 g/dL at discharge, 11.7 ± 1.7 g/dL at first month, 11.8 ± 1.4 g/dL at first year (Hemoglobin values compared with pre-TAVR, P < .001, P = .019, P = .047, respectively). Mean platelet volume (MPV) before TAVR 8.72 ± 1.71 fL, 8.16 ± 1.46 fL at discharge, 8.09 ± 1.44 fL at first month, 7.94 ± 1.18 fL at first year (MPV values compared with pre-TAVR, P < .001, P < .001, P < .001, respectively). Other hematologic parameters were also evaluated. Hemoglobin, platelet count, MPV, and red cell distribution width before the procedure, at discharge, and at the first year did not predict mortality and major bleeding in receiver operating characteristic analysis. After multivariate Cox regression analysis, hematologic parameters were not independent predictors of in-hospital mortality, major bleeding, and death at 1 year after TAVR.
Is Plasma Atherogenic Index or Ldl/Hdl Ratio More Predictive of Peripheral Arterial Disease Complexity?
(Sage Publications Ltd, 2024) Aktan, Adem; Aktan, Adem; Altunova, Mehmet; Ozbek, Mehmet
Introduction: The most basic and well-known cause of peripheral arterial disease (PAD) is atherosclerosis. One of the main factors causing atherosclerosis is dyslipidemia. We will evaluate whether specific ratios of dyslipidemia, such as the atherogenic plasma index (AIP) and LDL/HDL ratio, which have recently been used in practice, can help us to predict the complexity of PAD in the clinic. Methods: A total of 305 patients with PAD admitted to our clinic were retrospectively included in this study. After evaluation according to angiography images using TASC-II classification, patients were divided into TASC A-B and TASC C-D. AIP was evaluated with the following formula: Log (TG/HDL). Cut-off values for AIP and LDL/HDL were determined on the ROC (receiver operating characteristic) curve. Logistic regression analysis were conducted to predict peripheral arterial disease complexity. Results: The mean ages of Group 1 (n:180, 68.3% male) and Group 2 (n:125, 77.6% male) patients were 64.10 +/- 12.39 and 64.94 +/- 11.12 years, respectively. The prevalence of diabetes mellitus (DM, p < 0.016) and coronary artery disease (CAD, p < 0.001) was higher in group 2. Group 2 had higher TG (p = 0.045), LDL-C (p = 0.004), AIP (p = 0.010), LDL/HDL (p < 0.001), and lower HDL-C (p = 0.015). In multivariate logistic regression analysis evaluating parameters in predicting PAD complexity, DM (OR: 1.66 Cl 95%: 1.01-2.73 p = 0.045), CAD (OR: 2.86 Cl 95%: 1.75-4.69 p < 0.001) and LDL/HDL (OR: 1.47 Cl 95%: 1.10-1.96 p = 0.008) were independent variables. Conclusion: In our study, we compared LDL/HDL ratio and AIP in PAD for the first time in the literature and showed that LDL/HDL ratio is a more valuable ratio and an independent predictor of PAD complexity.
Evaluation of Hematological Parameters After Transcatheter Aortic Valve Replacement
(SAGE, 2023) Günlü, Serhat; Karahan, Mehmet Zülkif; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Demir, Muhammed; Ertaş, Faruk
Although transcatheter aortic valve replacement (TAVR) is safe and effective, mortality and bleeding events post procedure are important. The present study investigated the changes in hematologic parameters to evaluate whether they predict mortality or major bleeding. We enrolled 248 consecutive patients (44.8% male; mean age 79.0 ± 6.4 years) undergoing TAVR. In addition to demographic and clinical examination, blood parameters were recorded before TAVR, at discharge, 1 month and 1 year. Hemoglobin levels before TAVR 12.1 ± 1.8 g/dL, 10.8 ± 1.7 g/dL at discharge, 11.7 ± 1.7 g/dL at first month, 11.8 ± 1.4 g/dL at first year (Hemoglobin values compared with pre-TAVR, P < .001, P = .019, P = .047, respectively). Mean platelet volume (MPV) before TAVR 8.72 ± 1.71 fL, 8.16 ± 1.46 fL at discharge, 8.09 ± 1.44 fL at first month, 7.94 ± 1.18 fL at first year (MPV values compared with pre-TAVR, P < .001, P < .001, P < .001, respectively). Other hematologic parameters were also evaluated. Hemoglobin, platelet count, MPV, and red cell distribution width before the procedure, at discharge, and at the first year did not predict mortality and major bleeding in receiver operating characteristic analysis. After multivariate Cox regression analysis, hematologic parameters were not independent predictors of in-hospital mortality, major bleeding, and death at 1 year after TAVR.
Local Against General Anesthesia For Transcatheter Aortic Valve Replacement
(Bandırma Onyedi Eylül Üniversitesi Tıp Fakültesi, 2023) Günlü, Serhat; Kayan, Fethullah; Aktan, Adem; Karahan, Mehmet Zülkif; Tanırcan, Muhammed Raşid; Karahan, Mehmet Zülkif
Background/Aims: Transcatheter aortic valve replacement (TAVR) poses significant challenges concerning anesthesia management. There is no consensus on the type of safer anesthesia for TAVR procedures. We aimed to evaluate the effectiveness and safety of TAVR performed with trans-femoral approach under local anesthesia with sedation (LAS) against general anesthesia (GA). Methods: This observational and retrospective analysis included individuals who were admitted on a planned basis from 2016 to 2022 and underwent Transfemoral TAVR. Effectiveness and safety outcomes were evaluated at 30 days. İndividuals were separated into two groups: GA and LAS. Demographic characteristics and procedural data were recorded during hospitalization. Results: 115 patients were included, of whom 62 (53.9%) received LAS and 53 received GA (46.1%). 59 female (48.8%) patients with a mean age of 83.2±5.7 participated in the study. Successful TAVR procedure was performed in 100 (86.9%) of 115 patients with the transfemoral approach. The mean procedure time was 136.7±46.7 minutes, and the procedure time was shorter in patients who underwent LAS against GA (p=0.001). There were no differences among the groups including fluoroscopy time, contrast, and radiation dose (p>0.05). In 2 patients (3.2%), significant vascular complications necessitated immediate surgical intervention, necessitating a change in the anesthesia technique. Overall 30-day mortality was 5.2%, with no significant differences among the groups (GA 7.5% vs. LAS 3.2%, p =0.28). GA had substantially longer ICU and total hospitalization stays than LAS (p=0.009 and p =0.004, respectively). Conclusions: In our study, TAVR via the transfemoral route using LAS was an alternative for GA.
Evaluation of Frontal QRS-T Angle in Patients with Coronary Artery Ectasia
(Sociedade Brasileira de Cardiologia – SBC, 2023) Günlü, Serhat; Karahan, Mehmet Zülkif; Aktan, Adem; Kayan, Fethullah; Günlü, Serhat
Background: Coronary artery ectasia (CAE) is defined by focal enlargement of the coronary artery exceeding 1.5 times the adjacent normal segment. CAE can often cause arrhythmias, heart failure, sudden death, and myocardial ischemia. Ischemia due to microvascular dysfunction may be responsible for the ventricular heterogeneity in CAE. Objectives: The aim of our study was to evaluate the frontal QRS-T angle in patients with CAE. Methods: Our study included 55 patients with CAE and 50 individuals in the control group. Demographic characteristics and electrocardiographic parameters were compared between the two groups. Categorical variables were compared using the chi-square test. Continuous variables were compared using unpaired Student’s t-test. P values < 0.05 were considered statistically significant. The frontal QRS-T angle was calculated from 12-lead electrocardiograms (ECGs) using the automatic report from the electrocardiography machine. Results: The average age of patients with CAE was 63.2 ± 3.4 years, with 18 women among them. The control group had an average age of 61.1 ± 3.2 years, with 28 women included. There was no significant difference in demographic parameters between the two groups. Compared to the control group, patients with CAE had significantly wider frontal QRS-T angle (p < 0.001), as well as longer QTmax duration, p = 0.002; Tp-Te interval, p = 0.02; and QT dispersion (QTd), p = 0.04. Conclusion: The frontal QRS-T angle can be calculated easily and time-efficiently using surface electrocardiography. In this study, we showed for the first time that the frontal QRS-T angle was significantly increased in patients with CAE.
Prevalence of Sarcopenia in Heart Failure With Mildly Reduced Ejection Fraction and Its Impact on Clinical Outcomes
(Taylor & Francis Ltd, 2024) Aktan, Adem; Guzel, Tuncay; Aktan, Adem; Guzel, Hamdullah; Kaya, Ahmet Ferhat; Arslan, Bayram; Karahan, Mehmet Zuelkuef
Background: Sarcopenia is a progressive age-related skeletal muscle disease associated with adverse outcomes in those with cardiovascular disease. In this study, the prevalence of sarcopenia and its effect on clinical outcomes in heart failure with mildly reduced ejection fraction (HFmrEF) patients were examined. Methods: A total of 722 patients from three centres who applied to the outpatient clinic with the diagnosis of HFmrEF between 01 January 2020 and 01 June 2021 were included in the study retrospectively. Sarcopenia was diagnosed with a screening test using age, grip srength and calf circumference. At least two-year follow-up results were reviewed from the date the patients were included in the study. Results: Of the 722 HFmrEF patients, 169 (23.4%) were sarcopenic. During the follow-up of sarcopenic patients, a higher rate of hospitalisation and two-year mortality was detected compared to the non-sarcopenic group (49.7% vs 33.3%, p < .001 and 23.7% vs 13.2%, p = .001, respectively). Additionally, atrial fibrillation (AF), chronic obstructive pulmonary disease (COPD), chronic renal failure (CRF) and smoking were detected at higher rates in sarcopenic patients. In subgroup analysis, AF was found to be significantly higher in overweight/obese sarcopenia patients compared to other groups. According to Receiver operating characteristic (ROC) analysis, the sarcopenia score cut-off of 73.61 predicted mortality with 65% sensitivity and 63% specificity, and the cut-off level of 71.10 predicted hospitalisation with 68% sensitivity and 69% specificity. Conclusion: In HFmrEF patients, sarcopenia is associated with adverse events and is an important prognostic marker.